Kamala and Medicare

So folks, here is a question. Let’s say Kamala Harris (or whoever, it doesn’t matter) manages to do the Medicare for all / no private insurance system thing. Where do you think the very rich Kamala will get her medical care? Within the Medicare system or with a bunch of expensive private doctors her rich husband can hire by the boatload?

What I anticipate is that I’ll be stuck paying more taxes and getting crappier care (like in Canada) while the rich lady Kamala won’t experience any negative consequences of this. I mean we’ve all seen her. Can anybody honestly imagine her sitting in line for 6 hours at a state hospital (like I did in Canada) or being told by a state doctor that he doesn’t have time to look at her test results (like my sister was in Canada)?

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36 thoughts on “Kamala and Medicare”

Don’t worry, it’s not going to happen in America anytime soon. I was rather bemused to hear Harris make such an absurdly radical statement in her CNN interview (that she plans to “abolish the insurance industry” so “nobody has to go through all the paperwork and wait for approval and not know if they’ll get treated, etc.”).

Statements like these suggest that her ignorance level on some issues may be a lot closer to AOC’s than Harris’s age and time in government service would indicate. She’s got to do a lot better than this to remain a viable candidate for the general election.

I was floored, too. She’s clueless to the point of ridiculousness. Rich people are all the same. Trump thinks you can get groceries on credit. She has no idea how health insurance works. But both pose as champions of the people. Where do they even see people? Out of the windows of their Jaguars?

In Canada you are free to “choose” all you want. Problem is, nobody you choose wants to take you because they are overburdened, so you have to wait for months for a basic specialist appointment. I’m suspecting, though, that Kamala won’t be waiting.

I think there’s something I’m not getting here – why don’t more Canadians become doctors then?Are doctors horribly paid in this system? Is there a very small number of medical schools? Because I hear this problem had been going for a while, and I’d expect this sort of stuff to fix itself in a generation as kids realize a doctor’s diploma means great job security. And that is assuming immigration does nothing to fix this, which is a big assumption.

You think not but really, it all depends on what they mean by “medicare for all” and what the model is. This isn’t a proposal yet. If it is literally Medicare then what is available is going to vary by state and more factors. So exactly in the group of someone who is from another state and is now in the Senate, no. Ability to acquire really good coverage, yes, just as it is for those actually on Medicare now.

The main issue is that a lot of social service benefits are going to many of the non-citizens who entered the U.S. improperly, thus draining a lot of funds that could have instead gone to needy U.S. citizens.
Make those here illegally ineligible for receiving any kind of benefits from the U.S. government—keep them reserved for U.S. citizens only—and the idea of a “Medicare For All” proposal would be more feasible, as there would then be more funds available to help out some of the more vulnerable U.S. citizens themselves.

Undocumented aliens ALREADY do not have access to programs such as the Supplemental Nutrition Assistance Program (food stamps), Temporary Assistance for Needy Families (welfare), Social Security or Medicare, although they do pay taxes in direct and indirect ways. Yes, ERs will stabilize the uninsured, and tourists, etc., in emergencies but that does not mean actually treat.

“If it is literally Medicare then what is available is going to vary by state and more factors.”

MediCARE (currently for people over 65) is a federal program run from Washington with no state involvement. MediCAID (for eigible people with a very low income) is a federal and state program with benefits varying considerably from state to state.

Only Parts A and B are Federal and it is my understanding that what else is available varies. My father in California has Medicare + UC High Option Supplement, which is one of 5 options available to him. But not to all, because the possibilities are tied to his job; other people in other jobs have others.

Right. So my thought is, “Medicare for all” (if that’s what’s meant) would be on this model. Dad doesn’t go to a special, different hospital or doctors because of being on Medicare, he goes where he always went and some costs are paid by Medicare and others by the supplemental insurance.

So my assumption is that that is what would happen if we literally got “Medicare for all” — and people interested / able to afford it could get very good supplemental insurance?

“So my assumption is that that is what would happen if we literally got ‘Medicare for all’ — and people interested / able to afford it could get very good supplemental insurance?”

Kamala Harris literally said in her CNN interview that she wants to ABOLISH private insurance companies — and make all health coverage in America 100% government funded. She didn’t say if her plan (she really doesn’t have one) would require state governments to pay some portion of it.

I have a close friend who is unemployed/semi-retired and uninsured. The premiums for Obamacare are too high, so he can’t afford to enroll in it. The insurance he can afford sucks and he has to pay a lot out of pocket. For the last few months, he has had a series of doctor appointments to figure out why he has extreme pain around his chest area, and he has had to wait 1 1/2-2 weeks for each new appointment. I really don’t care where Kamala Harris gets her health care; the extreme income inequality in the U.S. means that the rich will always get what they want. Sure, I’d like to solve the problem of income inequality, but I’d also like to get health care for my friend even if Harris gets better and quicker care than my friend.

I don’t have a problem with income inequality. What I fear is that there will be superb care for a tiny minority and crap for everybody else. But that crap will be spread equally. And the system we will all get if we are not extremely rich will be the kind where your eye swells to the point where you can barely open it, and you are told you can see a specialist in 5 months. And when you finally do get seen you hear, hmm, I have no idea what this is but if it hurts, take a Tylenol (a true story from Canada).

This will definitely be better for those who currently have no insurance, and I admire people who are ready to say they are willing to have their standard of care go down while their taxes go up as long as nobody is uninsured. But I can’t find this spirit of charity in myself.

Or being told you have to wait nine months for an obstetric ultrasound? Yes, let me time my children so far in advance that I can actually make the ultrasounds when they tell me they have appointments. Didn’t happen to me, but to someone else. They had to fake emergencies just to their prenatal appointments because the private practices near them were too expensive.

@Dreidel, isn’t that unrealistic given how established these companies are?

I’m just not getting the paranoia that with change in payment system service becomes scarce. I am maybe not picky enough because I’ve never expected not to have to wait for an appointment. Last year for something I needed it took a long time to get in and was inconvenient but I just said yes well, sometimes you wait. So maybe I’m just too laid back on these things, I don’t know.

“@Dreidel, isn’t that unrealistic given how established these companies are?”

It’s far beyond unrealistic — the Democratic primary candidates today are spouting nonsensical, bizarre fantasies that could have been written as dialogue in Alice in Wonderland. What’s amazing is that not a single major Democratic politician has dared speak out publicly against the madness overtaking their party.

The only “life-long Democrat” to point out the truth is the totally reviled Howard Schultz. And of course he’s one of those evil “billionaires” who have no moral right to exist per AOC. Elizabeth Warren practically spits every time she says that word.

A number of lefty writers have accused Schultz of threatening to run as an independent in order to promote his book tour. But in a “Salon.com” article out today, aging feminist psycho Amanda Marcotte actually managed to state an equally plausible theory: that Schultz is trying to protect his billions by scaring the Democratic Party into backing off from its “destroy the rich” party platform.

“What about the alleged sudden dearth of MDs if we were go to single payer?”

I’m a retired physician who never worked in private practice on a for-fee basis, so I have no informed opinion about that. I’ve been on Medicare for eight years now, and my medical care since leaving the military has been excellent.

I suspect that if the federal government forced “Medicare for all” on the doctors currently accepting Medicare, the government plan would drastically reduce the per-visit payments to “fair” levels while vastly increasing the physicians’ patient load. That might drive a significant number of doctors into non-Medicare practice.

It’s not just a change in the payment source. It’s the Introduction of false egalitarianism into compensation, which happens in all large state systems. You get paid based on how many patients you push out the door and quality be damned. There is a million times more paperwork, humiliating ethics and sexuality trainings. And so on.

Of course, people who are good go to private practice instead. Or form concierge services to treat the Kamalas of the world. Or specialize in plastic surgery or dental.

But they definitely don’t move out to remote rural areas that are underserved.

Louisiana used to have the Charity system, that Jindal didn’t like for ideological reasons but it was good, and not second rate in terms of care, although you did have to wait in line and so on. It was open to all and then you could have private insurance as well, and go where you didn’t have to wait. Brazil had a version of this — all these programs date from the 30s or so and solved a lot, although not being perfect, and didn’t create this fearsome scenario.

The reason why Kamala is saying that the private insurance industry has to be demolished is that for as long as private insurance exists, doctors will simply refuse to accept the state insurance. This is what happened in Illinois and why I don’t have insurance from work any more. Instead, we are paying $600 more per month to have me and Klara on N’s private insurance which is actually quite crappy. I am formally entitled to state insurance from my work but it’s meaningless because doctors refuse to take it.

I had a horrible experience with our state medical care system in Illinois. So I don’t even mind paying ridiculous amounts for the private insurance because I don’t want to depend on the mercy of idiots in Springfield any more.

Having a high school class mate with cancer and no access to a doctor (she lives in Indiana), I think this discussion is out of touch with the reality facing a large portion of the US population. There are areas in Mississippi where if you have a heart attack, you have to drive two-plus hours for care. Good luck with that. There’s a reason life expectancy varies so widely across the US, or that wealth is the best predictor of life expectancy in this country. I may not like Harris, but nothing she is saying will make the system worse for most people than it already is.

“I may not like Harris, but nothing she is saying will make the system worse for most people than it already is.”

Except that it will destroy an insurance industry that employs thousands of people and will strip away insurance coverage that provides better care to millions of Americans than Harris’ fantasized 100% government-run healthcare system could possibly do.

Do the math. You could t tax the ultra-rich in this country at a 99% non-marginal tax rate and destroy their wealth, and you’d get enough money to run the government for — what?? Three months? Four months max?

And then what? You’d have your revenge on all those billionaires who were evil enough to haven been fabulously successful in life — but the government would have no more rich men’s gold to spend, and you’d have to start taxing the middle class at confiscatory rates that they couldn’t afford to pay, and then…

Take a look around the world. Capitalism — for all its faults — works at a national level, and socialism never has.

What would your suggestion be for getting the uninsured and underinsured, insured? I’m in a state group and I choose the PPO option that has the highest option and the most flexibility, and I’m very satisfied. It could be yet better, of course, but all in all … it’s fine. Then you have my neighbor who works for private industry. He makes more than I do but it’s a couple of tens of thousands more, not astronomically more. I discovered when he had some accident while working on the house, cracked a bone, and I gave him ride to MD that his premium was about 3x mine and he wasn’t authorized to go to the (good) hospital I can go to. We went to the one I wouldn’t touch and fortunately, they said they were not competent to deal with this break, wrote a letter to get him into the hospital I can go to. He still had to wait 24 hours. And this was his job’s insurance plan, not one of those thin ones they designed here to barely comply with ACA. I was horrified. Then my friend, a professor at a private university here that is rich and you would think would have a good insurance plan, put her no preexisting conditions husband on it and the premium went up $500, and there are all these limits to it and all these things not covered. And yes she makes more than I do but again, not astronomically more. I was horrified again and glad again to be on the state plan. So … what to do?

“What would your suggestion be for getting the uninsured and underinsured, insured?”

I can’t envision a federal government program that can possibly cover every person falling under all the varying financial situations that you describe under a single blanket program — it would ultimately be too expensive for the government to sustain, unless those middle-class people were subject to excessive income taxes. It sounds like your friends who are in significantly different financial situations need to pay close attention to their employers’ health care plans, and supplement those employee programs with private insurance supplements to the extent financially affordable, and if possible keep aside an “emergency fund” to use for various family emergencies, including medical care. Depending on their income level, they may also be able to tap into state Medicaid low-income relief.

I realize that not every family can do all of this successfully — but there simply isn’t ANY single government health care program that can cover all their situations, and NO such plan is being realistically proposed by the radical Democrats like Harris, Sanders, and AOC. So for better or worse, these patients are on their own, and need to attempt the personal planning suggested above to the extent possible.

I think I left my comment in the wrong place. Look what happened to state workers and our health insurance in Illinois. I couldn’t take my infant child to a doctor because nobody wanted to accept the state insurance. I still have panic attacks about those horrible months.

Were you in the so-called quality care or a managed care option? If you choose the managed care option you can’t use the insurance many places.

Maybe I am just more cavalier, or too cavalier. I have gone to these urgent care storefronts sometimes when I need them and the MD is too busy. No, they don’t always take insurance, so you’re out for the office visit, $65 or something.

In terms of people living in remote areas who have trouble getting to the doctor fast, neither Harris nor anybody else is suggesting anything that would help those people. There is no way to force a group of doctors to move to remote corners of Mississippi and Indiana and sit there waiting for rare patients. Nobody is suggesting a remedy for these situations became unfortunately it doesn’t exist.